Effect of topical fluoride application and diode laser-irradiation on white spot lesions of human enamel

Abstract The formation of white spot lesions, or enamel demineralization, around fixed orthodontic attachments is a common complication during and following fixed orthodontic treatment, which marks the result of a successfully completed case. This article is a contemporary review of the risk factors and preventive methods of these orthodontics scars. Preventive programmes must be emphasized to all orthodontic patients. The responsibility of an orthodontist is to minimize the risk of the patient having decalcification as a consequence of orthodontic treatment by educating and motivating the patients for excellent oral hygiene practice. Prophylaxis with topical fluoride application should be implemented: high-fluoride toothpastes, fluoride mouthwashes, gels and varnishes during and after the orthodontic treatment, especially for patients at high risk of caries.

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STUDY OF THE EFFECT OF FLUORIDE ON LASER ENHANCED REMINERALIZATION OF DEMINERALIZED HUMAN ENAMEL

International Journal of Advanced Research ◽

10.21474/ijar01/12341 ◽

2021 ◽

Vol 9 (01) ◽

pp. 650-654

Author(s):

Hanan Mansour Abdallah ◽

◽

Reham Magdy Ameen ◽

Khaled El-Haddad ◽

◽

...

Keyword(s):

Diode Laser ◽

Early Stage ◽

Control Group ◽

Surface Microhardness ◽

Fluoride Toothpaste ◽

Hardness Tester ◽

Human Enamel ◽

Demineralized Enamel ◽

Topical Fluoride ◽

Caries Lesions

Background: Enamel is regularly subjected to demineralization and remineralization under different oral circumstances. Any interruption in the balance between demineralization and remineralization can initiate the formation of incipient caries lesions. However, in the early stage of formation these lesions can be remineralizedusing various preventive measures. Topical fluorides have shown positive results in the prevention of caries in several studies. The aim of this study was to determine the effects of combination between diode laser and topical fluoride application on the surface microhardness of the demineralized enamel. Materials and Methods: Four caries-free human premolars were examined under the stereomicroscope to exclude teeth with surface enamel defects. Buccal enamel surface microhardness (SMH) for all samples was measured by Micro Vickers Hardness Tester (MVHT). The samples were demineralized by 15% Hydrochloric acid (HCl) with PH average 4.5, then the SMH was measured. The demineralized teeth were subjected to fluoride toothpaste after diode laser application. Third evaluation for enamel SMH was performed after remineralization. Results: Enamel SMH of the control group has shown the highest values followed by the remineralization group while the least values were measured in the demineralization group. Conclusions: The results obtained in the study lead to the conclusion that application of fluoride toothpaste after diode laser could enhance the remineralization potential of the demineralized enamel.

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Effect of topical fluoride gel and fluoride varnish in the prevention of white spot lesions in patients undergoing fixed orthodontic treatment: An in vivo study

APOS Trends in Orthodontics ◽

10.25259/apos_170_2020 ◽

2022 ◽

Vol 11 ◽

pp. 301-308

Author(s):

Vivek Kumar Thakur ◽

Raghuvinder S. Vats ◽

M. P. Prasanna Kumar ◽

Sanjeev Datana ◽

Mohit Sharma ◽

...

Keyword(s):

Orthodontic Treatment ◽

Visual Observation ◽

Primary Objective ◽

Laser Fluorescence ◽

White Spot ◽

Fluoride Varnish ◽

White Spot Lesions ◽

Orthodontic Bracket ◽

Topical Fluoride

Objectives: Our primary objective was to establish the efficacy of fluoride gel and fluoride varnish in the prevention of white spot lesions (WSLs) development during fixed orthodontic treatment. Materials and Methods: The study sample consisted of 60 adult patients in a prospective split-mouth study design. Interventions, that is, topical fluoride gel and topical fluoride varnish were assigned at the time of bonding to either the right or left halves of the dentition. In all subjects, repeated evaluation of demineralization was done on the facial surfaces of sample teeth in each quadrant. Evaluation using laser fluorescence and by direct visual observation under magnification was carried out at bonding (T0), 3 months (T1), and 6 months (T2). Results: The distribution of mean DIAGNOdent score at T1 (3.14 ± 1.00 vs. 2.81 ± 0.852) and T2 (4.17 ± 1.41 vs. 3.51 ± 1.13) was observed which is significantly higher in the Gel group compared to the Varnish group. In the Gel group, the distribution of mean DIAGNOdent score at T1 (3.14 ± 1.00) and T2 (4.17 ± 1.41) is significantly higher compared to mean DIAGNOdent score at baseline T0 (2.07 ± 0.66). In the Varnish group, the distribution of mean DIAGNOdent score at T1 (2.81 ± 0.852) and T2 (3.51 ± 1.13) is significantly higher compared to the mean DIAGNOdent score at T0 (2.07 ± 0.66). Visual scores also correlated with DIAGNOdent scores. Conclusion: Fluoride varnish is more efficacious than fluoride gel in reducing enamel demineralization. Initial application of fluoride varnish around the orthodontic bracket at bonding appointment can offer significant protection against WSLs.

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In Situ Effect of Titanium Tetrafluoride and Sodium Fluoride on Artificially Decayed Human Enamel

Brazilian Dental Journal ◽

10.1590/0103-6440201302329 ◽

2014 ◽

Vol 25 (1) ◽

pp. 28-32 ◽

Cited By ~ 7

Author(s):

Paula Cristina da Costa Alcântara ◽

Adilis Kalina Alexandria ◽

Ivete Pomarico Ribeiro de Souza ◽

Lucianne Cople Maia

Keyword(s):

Sodium Fluoride ◽

Positive Control ◽

Negative Control ◽

White Spot ◽

White Spot Lesions ◽

Titanium Tetrafluoride ◽

Human Enamel ◽

In Situ Conditions ◽

Control Samples

This study compared in situ the application of 4% titanium tetrafluoride (TiF4) solution and 2% sodium fluoride (NaF) gel on artificial white-spot lesions in human enamel. A crossover, double-blind study using in situ caries models was carried out. Eleven volunteers used an intraoral appliance containing five demineralized human enamel blocks. The blocks (n=170) were randomly divided according to treatment into the following groups: TiF4 (n=55), NaF (n=55), positive control (n=55). A negative control group was composed of demineralized specimens (n=5). The microhardness test was performed using a Knoop penetrator. Energy dispersive spectrometer (EDS) was used to analyze the concentration of titanium, calcium, phosphate and oxygen. The enamel microhardness at different depths for TiF4, NaF and positive control samples was not statistically different (p>0.05). The samples from these three groups had statistically higher microhardness values than the negative control samples (p<0.05). EDS analysis did not provide conclusive results about the penetration of titanium in the TiF4 samples. While in some fragments it had substantial penetration, in other fragments it only had superficial penetration. It was possible to conclude that, under in situ conditions, 4% TiF4 solution and 2% NaF gel were able to remineralize artificial white-spot lesions in human enamel. However, the magnitude of the remineralization did not differ between groups.

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Evaluation of Remineralisation Potential of Zingiber officinale Roscoe-Apis Mellifera, and Chitosan as compared to control using QLF on white spot lesions: An in-vitro study

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i4.3144 ◽

2020 ◽

Vol 11 (4) ◽

pp. 5274-5281

Author(s):

Shefali Kaul ◽

Brinda Suhas Godhi ◽

Raghavendra Shanbhog ◽

Chanchala H P

Keyword(s):

Apis Mellifera ◽

In Vitro Study ◽

Zingiber Officinale ◽

White Spot ◽

White Spot Lesions ◽

Area Of Interest ◽

Human Enamel ◽

Zingiber Officinale Roscoe ◽

Ginger Rhizome

Early detection and treatment of white spot lesions (WSL) is pivotal in caries control. Several commercially available products are available for WSL reversal. However, the majority of them are either synthetically derived or are not a hundred percent efficient. Thus there is an ever constant need to find newer, more efficacious products for the same. One of the parameters to quantify de and remineralization is by Quantitative Light Induced Fluorescence (QLF). Thus this study aims to evaluate and compare the remineralizing potential of Zingiber officinale Roscoe (Ginger rhizome), Apis Mellifera (Manuka Honey) mixture and chitosan on artificial demineralized human enamel using Quantitative Light Induced Fluorescence. 45 human enamel samples were randomly divided into a control and two test groups. An Area of Interest (AOI) measuring 4x4 mm on the buccal surface of each tooth was formed and all the samples were subjected to demineralization process for a period of 96 hours. Remineralization regime was then carried out with twice daily application of respective interventional agents for a period of 21 days. QLF readings were recorded at the end of demineralization (Baseline), Day 7, Day 14 and Day 21 and fluorescence images were analysed using QLF InpektorTM propriety software. The remineralization action of chitosan was found to be the highest with a statistically significant reduction (p<0.001) seen at the end of 7th, 14th and 21st day. Ginger- honey mixture also showed reduction in fluorescence levels but only after the 14th day. The current study showcases the dramatic ability of chitosan to almost completely reverse artificially formed WSL at each subsequent week. Ginger honey on the other hand showed a significant remineralization between 2nd and 3rd week which may be attributed to a possible slower mechanism of action.

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Caries Inhibition With Co2-laser During Orthodontic Treatment a Study Protocol for a Randomized Split-mouth Controlled Clinical Trial

10.21203/rs.3.rs-635890/v1 ◽

2021 ◽

Author(s):

Maria Shindova ◽

Ani Belcheva

Keyword(s):

Clinical Trial ◽

Laser Irradiation ◽

Study Protocol ◽

Orthodontic Treatment ◽

Assessment System ◽

White Spot ◽

Controlled Clinical Trial ◽

White Spot Lesions ◽

High Caries Risk ◽

Medical University

Abstract IntroductionWhite spot lesions associated with orthodontic treatment are a common problem. Recent studies reported increased resistance to acid demineralization of enamel after sub-ablative CO2-laser irradiation in a combination with fluoride application. The aim of the study is to assess the efficacy of CO2-laser in combination with a fluoride varnish in the prevention, severity and extent of white spot lesions during orthodontic treatment with fixed appliances.Methods and analysisThis is a protocol for a randomized, split-mouth controlled, clinical trial. The participants will be children aged 12-18 years at high caries risk, requiring fixed orthodontic treatment. The vestibular surfaces of maxillary anterior teeth of eligible patients will be exposed to CO2-laser irradiation in combination with fluoride therapy and fluoride therapy alone followed by bonding of orthodontic brackets. The patients will be recalled 6 and 12 months post-irradiation. Outcome measures will be visual examination with International Caries Detection and Assessment System criteria and SoproLife fluorescence. Data will be analyzed by Student t-test for paired samples and proportional odds logistic regression model, p˂0.05.Ethics and disseminationThe study protocol has been approved by the Committee for Scientific Research Ethics, Medical University-Plovdiv, Bulgaria (Reference number P-605/27.03.2020,Protocol of approval No. 2/01.04.2021) and registered on a publicly accessible database. This research received institutional funding from the Medical University–Plovdiv, Bulgaria. The results will be presented through peer-reviewed publications and conference presentations.Trial registration: ClinicalTrials.gov (Registration number: NCT04903275).

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The effect of fractional CO2 laser irradiation on remineralization of enamel white spot lesions

Lasers in Medical Science ◽

10.1007/s10103-013-1290-9 ◽

2013 ◽

Vol 29 (4) ◽

pp. 1349-1355 ◽

Cited By ~ 18

Author(s):

Maryam Poosti ◽

Farzaneh Ahrari ◽

Horieh Moosavi ◽

Hoda Najjaran

Keyword(s):

Laser Irradiation ◽

Co2 Laser ◽

White Spot ◽

White Spot Lesions ◽

Fractional Co2 Laser

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Comparision of two fluoride varnishes for controlling white spot lesions. Randomized clinical trial

REVISTA ODONTOLOGÍA PEDIÁTRICA ◽

10.33738/spo.v16i1.13 ◽

2017 ◽

Vol 16 (1) ◽

Author(s):

Jesús Alberto Luengo - Fereira

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

White Spot ◽

Controlled Clinical Trial ◽

White Spot Lesions ◽

Randomized Controlled Clinical Trial ◽

Chi Square ◽

Randomized Controlled ◽

Anterior Teeth ◽

The Mean

Objective: To compare two fluorinated varnishes for the control of white spot lesions.Material and Methods: A randomized controlled clinical trial was conducted. A total of 103 active whitespot lesions on permanent upper anterior teeth from 24 patients, aged 7 to 9 years were randomly assigned totwo groups, G1: Duraphat® (n=52) and G2: DuraShield® (n=51). Weekly applications were perform for fourconsecutive weeks. Fifth week the dimension, regression and activity of the lesions were evaluated. Student’sT test, Wilcoxon Ranks and Chi square were used at 5% significance. Results: At the end of the study, the lesion reduction was observed in 69.7%, finding significant differences(p<0.05) in the mean of the initial and final dimensions in general (2.74 mm to 1.91 mm) and in each group, G1(2.84 mm to 2.03 mm), G2 (2.64 mm to 1.78 mm). In the activity of the lesions, it was found in the G1, 12 active and6 inactive lesions; while in G2, there were 14 active and 29 inactive; these differences were significant (p<0.05). Conclusions: The two evaluated products showed similar clinical efficacy in the remineralization of activewhite spot lesions after 4 weeks of therapy.

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